Torsion of the appendix testis

Radswiki et al.

Torsion of the appendix testis is the most common cause of an acute painful hemiscrotum in a child. The appendix testis is located at the upper pole of the testis (between the testis and the head of the epididymis).

The normal appendix testis is 1 to 4 mm in length, and it is oval or pedunculated in shape.

Blue dot sign:

  • classic finding on physical examination
  • small firm nodule is palpable on the superior aspect of the testis and exhibits bluish discoloration through the overlying skin
Ultrasound

Appendix testis is increased in size with an increase or decrease in echogenicity. Torsion of the appendix testis is frequently accompanied by hydrocele and scrotal wall thickening.

A spherical shape and size of 6 mm with no internal vascularity and peripherial vascularity on Doppler scan are highly suggestive of torsion.

Ultrasound - general index
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Article information

rID: 15611
Tag: cases
Synonyms or Alternate Spellings:
  • Torsion of epididymal appendix
  • Appendix testis torsion

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